<!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
<title>Online form filling data entry process‏</title>
<link href="css/style.css" rel="stylesheet" type="text/css" />

</head>
<body>	
		<form class="form-horizontal">
			<div class="control-group">
				<label class="control-label" for="inputEmail">INVOICE NUMBER</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">INVOICE DATE</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">PHONE NO</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">CUSTOMER NAME</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">CUSTOMER ADDRESS</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">CITY</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">STATE</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">ZIP</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">CUSTOMER EMAIL</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">CUSTOMER TYPE</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">PRICE PLAN</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">DEVICE NAME</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">PHONE COST</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">MINS</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">TEXT</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">EXTRA VALUE INCLUDE</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">DEALER NAME</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">COMPANY NAME</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">CITY_D</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">STATE_D</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">ZIP_D</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">EMAIL ID</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">DEALER NO</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">DEALER CODE</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			
			<div class="control-group">
				<label class="control-label" for="inputEmail">RETAIL NAME</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">EMAILID</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">RETAIL NO</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">RETAIL CODE</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">PAYMENT</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">DISCOUNT</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">TOTAL AMOUNT</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">PAYMENT MODE</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">CREDIT CARD TYPE</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">CREDIT CARD NUMBER</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">CARD EXPIRY DATE</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
			<div class="control-group">
				<label class="control-label" for="inputEmail">CREDIT RATE</label>
				<div class="controls">
					<input type="text" id="inputEmail">
				</div>
			</div>
		</form>
</body>
</html>